Heard on the Hill: Therapy Cap Update

Due to the comprehensive nature of the payroll tax holiday and federal unemployment benefits legislation passed December 23, 2011, it was difficult for congressional members to agree on long-term solutions on Medicare provisions, such as the Sustainable Growth Rate (SGR) and the therapy cap exceptions process. The 2-month extension of the cap exceptions process and SGR allows Medicare patients to continue to receive care above the current therapy cap amount of $1,880 and ensures that PTs will not see a 27.4% reduction in payment under the physician fee schedule until February 29.

Find out what APTA is doing this month to advocate for a long-term solution to the therapy cap exceptions process and a reformed payment system in this new Heard on the Hill prerecorded podcast and transcript.

Comments

Keep up the good work. Someday our legislators will understand the PT saves the system money be reducing costs elsewhere.

Posted by Davd Jeter
on 1/18/2012 1:29 PM

As a private practitioner I find this game we have to play every year appalling. The idea that anyone who operates on a 27.4% margin in the medical field would just prove that they are billing illegally. No one who is billing for what they do could possibly survive such cuts and would the ones who are the ones gouging the system. I sat and tried to cut 27.% out of my budget and could not do it without doing some very illegal things. Also I am just tired of congress holding a gun to PTs every year heads who are doing the right thing. It is time to get rid of the SGR and the cap and give PTs direct access. I would even be OK if they left the cap in place as we may use the exceptions policy about 1% of the time. Also lets level the playing field and the hospitals go byt the same cap and play by the same rules, but this will never happen because the hospitals have such deep pockets and their lobbies are to strong. Everything is set up for big business and small private practices are the only ones who suffer.

Posted by Lorne MacDonald
on 1/21/2012 12:15 AM

Thank you for all you're doing for our profession. I believe that through your efforts congress will recognize how necessary and cost effective PT is or the 99% will realize that congress is not working in their best interest and change will come. PT will shine through appropriate U.S. healthcare reform.

Posted by Betty Fackler -> @KQ\A
on 1/21/2012 12:26 AM

Eliminate the cap in all settings. Make PTA supervision uniform. It makes no sense a PTA can do home visits alone but needs the PT present to treat in a private clinic. Advocating for the cap in hospital settings is counterproductive to our profession. Separate PT and speach. It's another senseless rule for the two to split the cap.
Placing a cap on hospital out patient PT will not help your clinic one bit.
Making the ordering practioner have hospital privileges is another stupid idea. Let this pass and next we'll see the private clinic can only accept orders from 25 miles or less.